Competency Map: Nurse

PR1-1: Engage in reflective practice about one’s own beliefs and values related to client care that integrates genetics and genomics.

PR1-2: Articulate attitudes, values and beliefs that influence health care perspective about difficult genetic or genomic health care decisions.

PR2-1: Demonstrate appropriate care and concern for all clients throughout their referral, provision of direct care and follow-up to genetic services.

PR2-2: Demonstrate knowledge about accessing local/regional genetic and/or genomic resources.

PR2-3: Include genetic health care professionals in team building and collaborative strategies to optimize client outcomes.

PR2-4: Help client negotiate system barriers that limit access to genetic/genomic services.

PR2-5: Identify strategies that could be used to facilitate reimbursement for access to genetic/genomic services and/or tests.

PR3-1: Identify relevance of genetics/genomics to practice of your discipline.

PR3-2: Demonstrate awareness of the boundaries of one’s own professional practice in relation to genetics/genomics.

PR3-3: Perform regular self assessments to identify knowledge and skills deficits that could impact the quality of nursing care one provides to clients in need of genetic/genomic guidance, referral and resources.

PR3-4: Take action to meet identified knowledge and skills deficits related to genetics and genomics.

PR4-1: Evaluate genetic and genomic technologies used in client care.

PR4-2: Demonstrate use of genetic and genomic technology and client data for clinical decision-making in providing safe client care.

PR4-3: Identify the credibility, reliability and limitations of genetic and genomic information.

PR4-4: Identify ethical, legal, and social issues associated with genetic/genomic information.

PR5-2: Integrate knowledge from psychology, history, politics, sociology and culture when delivering genetic and genomic care.

PR6-2: Maintain confidentiality when recording genetic and genomic information.

PR6-3: Demonstrate awareness of the potential impact of genetic/genomic information on the individual and other family members.

PR6-4: Respond appropriately to inquiries about genetic and genomic health care concerns.

NA1 – 1: Collect a client’s personal and three generation family health history to assess for genomic factors that impact the client’s health.

NA1-2: Identify potentially significant information from a family history.

NA1-3: Identify clients who might benefit from referral to genetic specialists and/or information resources.

NA1-4: Facilitate appropriate referral to genetic specialists, accurately documenting and communicating relevant history and clinical data.

NA1-5: Describe a typical client journey that might be experienced in the process of genetic counseling.

NA1-6: Describe genetic/genomic factors that contribute to variability of response to pharmacologic agents.

NA1-8: Identify resources available to assist clients seeking genetic and genomic information or services including the types of services available.

NA2-1: Demonstrate ability to elicit a complete three-generation family health history.

NA2-2: Identify available family history tools to facilitate collection of family health history information.

NA3-1: Construct a pedigree from collected family history information using standardized symbols and terminology.

NA3-2: Identify available family history tools to generate and document a pedigree, e.g. Surgeon General’s Family Health Portrait.

NA4-1: Demonstrate ability to collect personal, medical and family history that includes genetic/genomic as well as environmental risks.

NA6-1: Identify genetic and genomic factors within collected history and physical assessment data that contribute to disease and/or health risks.

NA6-2: Demonstrate ability to incorporate family history as part of the nursing assessment.

NA6-3: Document family history information on three-generations on both maternal and paternal side, when available.

NA6-4: Document key genetic and genomic assessment information.

NA6-5: Identify components of assessment data that contribute to disease and/or health risks to establish a plan of care.

NA7-1: Demonstrate the ability to assess clients cultural, religious and ethnic perspectives with regards to genetics and genomics.

NA7-10: Demonstrate use of language appropriate to the client’s level of understanding and developmental age when explaining genetic and genomic information.

NA7-11: Demonstrate assessment of the clients’ understanding of genetic and genomic information.

NA7-12: Demonstrate assessment of social and psychological responses to genetic/genomic information.

NA7-2: Demonstrate an awareness of the client’s background in facilitating communication about genetic and genomic issues.

NA7-3: Demonstrate the ability to use resources to facilitate effective communication and access to genetic services.

NA7-4: Use communication skills to promote and check the client’s understanding of genetic and genomic information.

NA7-5: Demonstrate an awareness of client’s needs, showing fairness and sensitivity when exploring the rationale for seeking specialist genetic advice/referral.

NA7-6: Identify situations when the nurse’s own beliefs and values may have potential to influence the genetic and genomic care given to clients.

NA7-7: Identify situations where clients’ own beliefs and/or values influence genetic and genomic care choices.

NA7-8: Use communication skills to enable the client to express his or her own wishes, or to pursue a chosen course of action for genetic and genomic services.

NA7-9: Display a non-judgmental attitude at all times.

NA8-1: Develop, in partnership with the client, a health care plan that takes into account genetic and genomic determinants of health, available resources, and range of activities that contribute to health and prevention of illness, injury, disability and premat

NA8-2: Integrate best evidence, clinical judgment, client preferences, and family implications in planning genetic and genomic focused individualized care.

ID1-1: Identify factors in a family and health history that contribute to: disease susceptibility; disease characteristics, treatment, prognosis; or genetic/genomic condition.

ID1-2: Identify clients who may benefit from further evaluation of the identified disease susceptibility or genetic/genomic condition.

ID1-3: Demonstrate assessment of client concerns or understanding about information received from specialty genetic services (i.e., on-line genetic testing results).

ID1-4: Uses genetic and genomic indicators as rationale for clients who may benefit from further evaluation or other risk management interventions.

ID1-5: Incorporate into the interprofessional plan of care the need for further genetic/genomic evaluation or other risk management interventions in collaboration with the client.

ID2-1: Evaluate strengths, limitations, and best use of genetic and/or genomic resource for a client or group of clients.

ID2-2: Discuss the ways in which nurses can meet the educational, psychosocial and resource needs of clients and families affected by a genetic or genomic condition.

ID2-3: Discuss the ways in which nurses can meet the knowledge, psychosocial and resource needs of clients and families affected by genetic/genomic technology.

ID2-4: Identify resources available to assist clients seeking genetic and genomic information or services including the types of services available.

ID2-5: Develop a list of contacts and resources for genetic/genomic referrals.

ID2-6: Evaluate sources of evidence and clinical practice guidelines for a client whose care involves genetic and/or genomic health care. Use continuous quality improvement initiatives to update practice guidelines as necessary.

ID3-1: Demonstrate the ability to assess cultural, language, family values, traditions, health beliefs and religious perspectives that influence access to and use of genetic/genomic information, technology, and services.

ID3-2: Identify cultural, language, family values, traditions, health beliefs and religious perspectives that impact access and use of genetic/genomic information, technology and services.

ID3-3: Identify psychosocial issues and impact of genetic/genomic information, technology and services on individual and the family.

ID3-4: Use ethical principles when deliberating genetic/genomic issues of decision-making, privacy, confidentiality, informed consent, disclosure, access, and personal impact.

ID3-5: List action steps to address genetic/genomic ethical issues in practice, e.g. discuss with nursing team or supervisor, present to ethics committee.

ID3-6: Describe the influence of insurance or other methods of reimbursement for services on access to genetic and genomic information and technologies.

ID4-1: Identify respective genetic state legislation.

ID4-2: Identify examples of misuse of genetic/genomic information and technology.

ID4-3: Describe legal and social issues related to access and use of genetic information and technology.

ID4-4: Access interprofessional ethical resources when trying to resolve ethical dilemmas.

RA1-1: Develop an interprofessional plan of care in collaboration with the client that incorporates genetics and genomics.

RA1-2: Uses genetic and genomic indicators as rationale for clients who may benefit from further evaluation or other risk management interventions.

RA1-3: Develop a plan for follow-up of a client post genetics/genomic referral.

PECS1-1: Discuss factors in a family and health history that contribute to: disease susceptibility; disease characteristics, treatment, prognosis; or a genetic/genomic condition.

PECS1-2: Use family history information to inform health education.

PECS1-3: Discuss the role of genetic, genomic, environmental and psychosocial factors in the manifestation of disease.

PECS1-4: Discuss the role of genetic, genomic, environmental and psychosocial factors in the manifestation of disease.

PECS1-5: Reinforce/clarify information provided by genetic professional to client (i.e., genetic test interpretation; informed consent).

PECS2-1: Evaluate strengths, limitations, and best use of one genetic and/or genomic resource for a client or group of clients.

PECS2-2: Help clients interpret and understand genetic and genomic information.

PECS4-1: Demonstrate ability to incorporate family history as part of the nursing assessment.

PECS4-2: Monitor client response to genetic/genomic based interventions.

PECS4-3: Intervene when client has an unintended response to genetic/genomic based interventions to ensure client safety.

PECS5-1: Use interprofessional communication and collaboration skills to deliver safe, evidence-based, client-centered care.

PECS5-2: Demonstrate team building and collaborative strategies when working with interprofessional teams.

PECS5-3: Adopt a range of interpersonal skills whilst communicating with clients and colleagues about genetic/genomic issues.

PECS6-1: Identify strategies to facilitate reimbursement for genetic/genomic services and/or tests.

PECS6-2: Describe other methods of payment for genetic/genomic health care services (i.e., laboratory indigent assistance programs).

PECS7-1: Administer medications safely with consideration of pharmacogenetic test results if available.

PECS7-2: Administer prescribed genetic / genomic based therapies safely as allowed per State Practice Act.

PECS7-3: Teach client about purpose, expected benefits, limitations and potential risks of genetic/genomic based interventions.

PECS8-1: Assess client response to genetic/genomic information.

PECS8-2: Assess client response to genetic/genomic based interventions.

PECS8-3: Assess client response to genetic/genomic services.

PECS8-4: Use evaluation of genetic/genomic technology, information and interventions to modify client’s plan of care.